Individual
KIMBERLY DORVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 CHADWICK STREET, WINSLOW, ME 04901
(207) 877-1636
Mailing address
16 CHADWICK STREET, WINSLOW, ME 04901
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OA2420
ME
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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